title: Are adults with bipolar disorder active? Objectively measured physical activity and sedentary behavior using accelerometry.
abstract: BACKGROUND
  Little is known about physical activity and sedentary behavior of adults with bipolar disorder (BP). Physical activity and sedentary behaviors may be modifiable factors associated with elevated rates of obesity, diabetes, cardiovascular disease, metabolic syndrome, and mortality in adults with BP.
  
  
  METHODS
  Sixty adult outpatients treated for BP (> 18 yr) wore accelerometers for seven consecutive days. Each minute epoch was assigned an activity level based on the number of counts per minute; sedentary(<100 counts), light(101-1951 counts), or moderate/vigorous(>1952 counts). Adults with BP were matched 1:1 to users and non-users of mental health services (MHS) (NHANES 2003-2004) by gender, closest BMI, and age.
  
  
  RESULTS
  On average, adults with BP wore actigraphs over 17 h/day. The majority of monitoring time (78%) was classified as sedentary (approximately 13.5h/day). Light physical activity accounted for 21% of the monitoring time/day (215 min/day). None achieved 150 min/wk of moderate/vigorous activity as recommended by national guidelines. Adults with BP were significantly less active and more sedentary than MHS users and non-users in NHANES 2003-2004 (p<0.01).
  
  
  CONCLUSIONS
  Majority of the participants were relatively asymptomatic with most (87%) having no more than mild depressive symptoms and none experiencing severe manic symptoms. The sedating effects of medications on physical activity were not investigated.
  
  
  CONCLUSIONS
  From clinical perspectives, these findings justify physical activity interventions targeting adults with BP as a possible means to improve their physical and mental health and to reduce the elevated risk of commonly observed medical comorbidities in this high-risk population.
authors.affiliation: Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, United States; Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States. Electronic address: carol.janney@va.gov.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Janney
authors.forename: Andrea
authors.initials: A
authors.lastname: Fagiolini
authors.forename: Holly A
authors.initials: HA
authors.lastname: Swartz
authors.forename: John M
authors.initials: JM
authors.lastname: Jakicic
authors.forename: Robert G
authors.initials: RG
authors.lastname: Holleman
authors.forename: Caroline R
authors.initials: CR
authors.lastname: Richardson
mesh_terms: D061725:Accelerometry / Q000379:methods; D001714:Bipolar Disorder / Q000523:psychology*; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D057185:Sedentary Behavior; D012737:Sex Factors
keywords: Actigraphy; Bipolar disorder; Mental health services; NHANES 2003–2004; Physical activity; Sedentary behavior